Technology

Scientists in the UK have developed a new material that can be inserted into teeth to repair and regenerate dentin – the hard, bone-like tissue that makes up the bulk of all teeth.

Just like regular fillings, which are inserted into a tooth to block off spaces where bacteria could colonise, the new material is injected into the tooth and hardened with UV light. But once inside the pulp of the tooth, it actually encourages stem cells to proliferate and grow into dentin.

“We have designed synthetic biomaterials that can be used similarly to dental fillings but can be placed in direct contact with pulp tissue to stimulate the native stem cell population for repair and regeneration of pulp tissue and the surrounding dentin,” says lead researcher Adam Celiz, a therapeutic biomaterials researcher from the University of Nottingham.

The technique just won second prize in the materials category of the UK Royal Society of Chemistry’s Emerging Technologies Competition 2016, and while there’s not a whole lot of information available about how it actually works, it appears to be a new form of ‘pulp capping’.

Pulp capping is a technique dentists use to try and stop dental pulp from dying. Pulp is one of the four major components of teeth, along with enamel, dentin, and cementum.

The surface enamel is the hardest layer, and under that is the second hardest layer, dentin. Dentin is important because it surrounds and connects to the pulp of the tooth, which is made up of living connective tissue and cells called odontoblasts, and found in the middle of your tooth.

The pulp is where your blood vessels, nerves, and connective tissue are found, so you really don’t want to mess that up.

Problems start when you get a cavity that eats away your enamel, dentin and cementum – a calcified substance covering the root of a tooth – and exposes the pulp. If dentists don’t get in there fast enough with a protective pulp-capping substance (or if the procedure fails), you’re looking at an expensive and painful root canal treatment.

Right now, pulp capping materials are usually made of materials such as calcium hydroxide or Mineral trioxide aggregate (MTA), and they don’t do anything other than protect, and around 10 to 15 percent of these fillings fail.

That’s where the University of Nottingham’s invention comes in. Their new pulp capping material is designed to stop pulp capping failure by encouraging the growth of more natural dentin to protect it.

“In in vitro testing, the fillings stimulated the proliferation and differentiation of stem cells into dentin, the bony tissue that forms the bulk of the tooth under the white enamel.

The researchers believe that if used in a damaged tooth, those stem cells can repair the kind of damage that often comes from the installation of a filling. In essence, the biomaterial filling would allow the tooth to heal itself.”

As mentioned earlier, the team hasn’t released a lot of information about their new material, and have yet to publish it in a peer-reviewed journal, so we’ll have to be cautiously optimistic about it for now until we can see more information about exactly how it works, and how expensive it will be.

Cancer stem cells can take cover and evade chemotherapy by hiding in fatty tissue, according to new research.

A team of scientists in the US looked at the behaviour of leukaemia stem cells in mice and found they were building their own hideout in the fat – a bolt-hole that then increased their resistance to chemo treatments.

Not only that, but the cancer cells apparently use the fatty deposits to generate extra energy for themselves. The researchers say this activity could help explain why some cancers prove harder to treat, and are more likely to recur.

The fatty tissue acts as a kind of “robber’s cave” for the cancer cells, according to the team from the University of Colorado Cancer Centre.

When analysing a mouse model of leukaemia, the researchers noted the fatty (or adipose) tissue had a higher concentration of cancer stem cells to regular cancer cells.

Like healthy stem cells, cancer stem cells are capable of developing into several cell types, and are thought to form new tumours and cause relapses.

Credit: University of Colorado Cancer Centre

These cancer stem cells were also found to be triggering a process called lipolysis, where fatty acids are released from tissue to produce energy: in essence, the cells were creating a new energy source for themselves.

When a chemotherapy treatment was introduced, the cancer stem cells hiding in the fatty tissue and living off its acids were noted to be more resistant than the other cancer stem cells outside the tissue. The same effects were found in samples of human leukaemia.

Three clues prompted the scientists to carry out their research: obesity is already linked to a poorer recovery rate for leukaemia patients; cancer stem cells drive growth and can cause relapses in leukaemia; and they rely heavily on the tumour micro-environment they’re in.

With those factors in mind, the researchers wondered – could cancer stem cells in fatty tissue be causing poorer prognosis in obese patients? From the new findings, it seems the answer could be yes, although this is still just a hypothesis for now.

The researchers intend to follow up their study by testing mouse models of different obesity levels, to see if extra fat provides more space for cancer stem cells to hide away in (or more energy for them to live off).

Obesity increases the risk of several cancer types, although scientists haven’t yet pinned down the reason why.

Although this new study doesn’t solve the problem, it means we’re getting closer, giving us new understanding into why leukaemia in overweight patients is harder to fight and more likely to come back.

Next month, Chinese researchers will edit adult human DNA using the revolutionary CRISPR/Cas-9 tool, commonly known as CRISPR, for the first time anywhere in the world.

The researchers will attempt to cut faulty DNA out of the cells of lung cancer patients who have failed to respond to all other conventional treatments.

Chinese scientists have previously used CRISPR on non-viable human embryos, without much luck, but this is the first time any researchers, anywhere in the world, will use the tool to edit DNA in an adult.

If successful, the hope is that it could lead to further CRISPR treatments – CRISPR/Cas-9 allows researchers to effectively cut and paste DNA in cells, and, in animals, it’s already been shown to treat genetic diseases such as Duchenne muscular dystrophy.

The new trial will begin at Sichuan University’s West China Hospital next month, according to Nature, and will involve patients who’ve already gone through chemotherapy and radiation therapy – in other words, are out of options.

In the past, scientists have spoken out about the ethical concerns surrounding the use of CRISPR, which is capable of causing genetic changes to sperm and egg cells that can be passed down to future generations.

There are also concerns that it could lead to the development of ‘designer’ babies – where parents pick and choose certain traits to write into their child’s DNA.

But it’s important to note that the new Chinese study will only edit patients’ immune system T-cells, and not affect gamete cells that could be passed down to offspring.

In other words, the changes made by CRISPR will be limited to the patient involved in the trial – a number that hasn’t been disclosed as yet.

We do know what the process will involve, though.

In the trial, the Chinese scientists will extract T-cells from patients’ blood and delete a gene that produces a protein called PD-1, which stops T-cells from targeting and killing cancer cells, from their DNA.

The team will then multiply these new CRISPR-modified T-cells in the lab, before injecting them back into the patients to flood their immune system.

The hypothesis is that, with PD-1 inhibited, the T-cells will be able to track down and wipe out lung cancer cells naturally.

While CRISPR/Cas-9 is capable of also inserting new DNA into a cell’s genome, in this study, genetic information will only be deleted, not added.

But what’s different in this case is the use of CRISPR, which is incredibly simple and versatile.

While in the past it’s taken years for scientists to develop the right molecular ‘scissors’ to cut out specific genes, CRISPR simply needs to be programmed and can then work for any part of the genome – no costly development required.

Last month, the US National Institutes of Health (NIH) approved a similar trial in the states – although the American research will also add an extra gene to help combat three types of cancer: melanoma, sarcoma, and myeloma.

The research could begin as early as this year, but if reports are anything to go off, China will be the first to try out this incredibly powerful tool in humans.

With the advent of e-pharmacy, there is a need to amend the Drugs and Cosmetics Act 1940as it does not differentiate between offline and online pharmacies. The Government is seized of the issue and is working towards amending the existing law to develop a framework where the consumers are benefitted. This was stated by Mr. K. B. Aggarwal, Additional Secretary (Food and Drugs), Ministry of Health & Family Welfare, while launching a report at a session on ‘E-pharmacy in India – Last Mile Access of Medicines’, organized by FICCI.

Mr. Aggarwal said that e-pharmacy would allow easy availability of drugs at all hours. However, there were concerns with respect to legitimacy of e-pharmacies, patients’ safety and privacy, misuse of e-pharmacy and adverse effect on retailers’ business.

He said that there was a need to create e-pharmacy guidelines which allow proper tracking and monitoring of sales of drugs, authenticity of online pharmacists and prescriptions, details of patients, thereby helping in reducing drug abuse and counterfeiting. He added that linking a person’s Aadhar number with e-pharmacy would ensure correctness of person seeking medicines.

Mr. Aggarwal said that for ensuring privacy and confidentiality of information, deliberations were taking place and soon the suggestions will be put up for further discussions among the stakeholders. He added that the DCGI was working towards developing its online platform and the system should be stable by the end of December 2016.

Dr. S. Eswara Reddy, Joint Drugs Controller, Central Drugs Standard Control Organization, said that the Government was working towards drafting a new Drugs & Cosmetics Act, 2016 to meet the current regulatory requirements related to safety, efficacy and quality of drugs. For the government, pharmaceuticals was a priority sector, therefore it was critical to ensure that its regulations are strengthened. He added that there should be a standard format of prescriptions.

In his presentation Mr. Jayant Singh, Director, Frost & Sullivan, said that e-pharmacy was one of the technology advancements that is about to create a huge demand in the upcoming days. There was a huge demand for access models that help patients and consumers avail the convenience of medicine delivery without having to leave their homes. With the use of technology and access to inventory of multiple stores at a time, e-pharmacies can aggregate supplies, making otherwise-hard-to-find medicines available to consumers across the country.

Dr. Manisha Shridhar, Regional Adviser, World Health Organization, said that for sale of online drugs, in the EU legitimate online pharmacies will have to carry a logo and India could learn from their processes and create its own logo for e-pharmacy. She added that there was a need to work on Direct to Consumer (DTC) as with emergence of e-pharmacy many issues will emerge that would need to be deliberated upon.

In his presentation on the consumer survey, Mr. Afaq Hussain, Director, BRIEF Market Research, said that 90 per cent of the respondents were willing to buy medicines online as epharmacy brings with the convenience of ordering from mobile applications; all required medicines are available at one store/website; home delivery of medicines; better quality of medicines; better pricing and e-bill for tacking and reimbursement.

In his Special Address Mr. Arvind Gupta, Founder & Head, Digital India Foundation, said that there was a need to look at e-pharmacy sector in a comprehensive manner keeping in view the entire healthcare chain. He added that the Aadhar number should be integrated when a person seeks drugs from e-pharmacy to monitor drug abuse and its misuse. He added that there was a need to standardize labs to create digi lockers where the patients’ records are safely documented for reference by doctors.

Dr. A Didar Singh, Secretary General, FICCI, said that there was an urgent need to nurture the e-pharmacy sector with the right set of policy frameworks and guidelines in order to provide the benefits that the sector fosters for the consumers. As one of the key agenda of the Government has been to provide easy, quality and affordable access of health services to the consumers, the evolving concept of e-pharmacy will definitely give an impetus to the health sector of the country

So finding anything that can treat bacterial infections without antibiotics is incredibly exciting for scientists.

UTIs are usually caused by E. coli (Escherichia coli) or other bacteria entering the urinary tract and attaching to the cell wall of the bladder, urethra, or kidneys (with kidney infections being the most severe).

Researchers already know that the bladder has a bunch of defence mechanisms it uses to try and minimise infection. One of these involves the lining of the bladder shedding frequently, so any bacteria that attach get washed out.

But that doesn’t work in all cases, and if E. coli does manage to attach to the bladder wall, the resulting infection can be painful, and unpleasant – especially if antibiotics aren’t able to clear it. There are currently 8.1 million doctors’ visits annually in the US just as a result of UTIs.

But now Duke University researchers have shown in detail for the first time a pathways through which bladder cells can actually kick out the bacteria that cause UTIs – and are now looking into how they can harness it to treat the infections without antibiotics.

“We found that the process which cells use to secrete chemicals also appears to be the way to clear urinary tract infections,” said Yuxuan Phoenix Miao, one of the researchers, in an interview with ResearchGate.

“Bacterial pathogens hide within a membranous vesicle in the bladder cells,” said Miao. “We revealed that a protein complex important for secreting hormones called ‘Exocyst’ can precisely recognise and locate bacteria hiding in those vesicles, then promote transport of these bacteria-laden vesicles towards the cell surface, and throw the bacteria out of the bladder cell.”

Even cooler, bladder cells can tag those vesicles with bacteria inside, so the immune system can remove the offending bacteria.

To do that, the immune system usually sends in lysosomes – organelles that eat and break down virtually anything in a cell, including bacteria. But occasionally the bacteria manage to survive this process, and when a lysosome eventually bursts, the freed bacteria go back and re-infect the cell.

But last year the same researchers also discovered that lysosomes can detect if the bacteria they’ve eaten isn’t breaking down, and vomit up the offending bacteria – which means they can be cleared away by other parts of the immune system.

“It was thought that lysosomes always degrade their contents,” Miao said last year. “Here we are showing for the first time that when the contents cannot be degraded, the lysosome appears to have a back-up plan which is to expel the contents in capsules.”

So, in other words, the team has shown in detail how our cells have the ability to clear even the most stubborn of bacteria – which means they can look for ways to tweak the process to make sure it happens more regularly, and on demand.

The researchers are now looking into current medicines and other substances to see if they can trigger this natural clearing mechanism with more accuracy and control. The plant extract Forskolin is currently a possible candidate for testing.

“Previous studies from our lab have found that Forskolin can dramatically enhance the bacteria clearance effect by promoting the bacteria export process,” said Miao. “Now that we have identified the pathway which the bladder cells use to export bacteria, we can start to examine whether Forskolin enhances bacteria expulsion by promoting the function of the Exocyst and if so, how.”